title: Changing adolescent health behaviors: the healthy teens counseling approach.
abstract: BACKGROUND
  Brief motivational interventions that have been provided in addition to routine primary care have changed adolescent health behaviors. Whether health screening and motivational-interviewing-based counseling provided by clinicians during routine care can change behaviors is unknown.
  
  
  METHODS
  Healthy Teens was a primary care, office-system intervention to support efficient, patient-centered counseling at well visits. Healthy Teens utilized a personal digital assistant (PDA)-based screener that provided the clinician with information about a teen's health risks and motivation to change. Changes in adolescent self-report of diet and activity health behaviors 6 months later were assessed in two cross-sectional samples of teens from five rural practices in 2005 and 2006. Usual-care subjects (N=148) were recruited at well visits prior to the intervention, and the Healthy Teens subjects (N=136) were recruited at well visits after the Healthy Teens system was well established.
  
  
  RESULTS
  At 6-month follow-up, the Healthy Teens group had significantly increased self-reported exercise levels and milk-product intake. In the models exploring covariates, the only significant predictors for improvement in exercise levels were intervention-group status (p=0.009) and post-visit interest in making a change (p=0.015). Interest in changing predicted increased milk intake (p=0.028) in both groups. When teens planned an action related to nutrition, physical activity, or both after a well visit, Healthy Teens participants were more likely to report multiple planned actions (68% Healthy Teens vs 32% usual care, p<0.05).
  
  
  CONCLUSIONS
  Changes in office systems using low-cost technology to screen adolescents and promote patient-centered counseling appear to influence teens to increase exercise and milk intake.
authors.affiliation: Department of Pediatrics, Dartmouth Medical School, Lebanon, New Hampshire 03756, USA. Ardis.Olson@Dartmouth.edu
authors.forename: Ardis L
authors.initials: AL
authors.lastname: Olson
authors.forename: Cecelia A
authors.initials: CA
authors.lastname: Gaffney
authors.forename: Pamela W
authors.initials: PW
authors.lastname: Lee
authors.forename: Pamela
authors.initials: P
authors.lastname: Starr
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000818:Animals; D002648:Child; D034201:Computers, Handheld; D003430:Cross-Sectional Studies; D037001:Directive Counseling / Q000379:methods*; D015444:Exercise / Q000523:psychology; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008892:Milk; D009042:Motivation; D009513:New Hampshire; D011320:Primary Health Care / Q000379:methods; D019035:Rural Health Services / Q000458:organization & administration; D014707:Vermont; D055815:Young Adult